About your Search

20121201
20121231
Search Results 0 to 4 of about 5 (some duplicates have been removed)
on november the 27, it specifically mentions a section, 1311 of aca, which directs quality health plan issues and improvement strategies as directed by the secretary, specifically subsection 8 of 1311 would allow the secretary to prevent physicians treating patients in exchanges unless they implement such mechanisms to improve health care quality the secretary may require. physicians must follow quality directives as defined by the secretary or lose their business. mr. smith, are you aware of this provision? >> i am not familiar with that section. >> let me ask you this. in this provision, you may not know this either, but the word quality is not defined in the statute. it is safe to assume that the secretary, not just secretary sebelius, but every secretary to follow, would be able to define for regulation what that word quality means. yes or no? >> i believe that is the correct interpretation. again, we have tried to introduce quality performances into a variety of parts of our programs, both in managed care, both in the fee-for-service world, and this is another one of our concerns that we
a loss so vast. the aca is not just above the expansion of medicaid or establishing an insurance exchange, it is about the hundreds of federal mandates and procedural requirements that have the escaped public attention, but to which we by law must obey. the fine print of the legislation is so complex, even the federal government struggles to understand it. the states cannot fully understand the impact on finances, systems changes, and operations. this law completely overwhelms society's safety net for the needy. there are a few problems in pennsylvania created by the aca. the law mandates that we expand our provider enrollment system to check with their medicare data. medicare databases cannot handle automated changes. we will have to add staff resources to respond to 100,000 inquiries every month. we are mandated to create separate databases to accommodate is exchanges and some databases like the masterfile, we have not been given access to. we adopt past medicaid rules radically changing the tailor- made renewal system that took years to refine and perfect. the verification system will
that must be covered by any health plan offering a plan in the aca exchange. i understand this has far reaching consequences on premiums. benefits must be provided. according to the notice in the federal register, the rule was approved by administrator on august 1, 2012. that is three months before. yet the role did not receive approval from secretary sebillius until two weeks ago. what did it take two month for the administration staff to review -- and yet the public will have only four weeks to review during the period of public comment on the ruling issued on november 26? i would note this is a time of year when people's focus is generally on things other than long awaited rules. >> we put a bulletin on the essential health benefits quite some time ago and got comments on the bulletin. the public had an opportunity to provide public comment on essential health benefits before the proposed rule was put out. there were some changes from what had been in the bulletin, but by and large what is in the bulletin is what is a in the proposed rule. i think there has been ample opportunity fo
gone too far? i personally think my position on a.c.a. is a good position and protecting the people's right to know is a high priority. >> what have you decided to do with all your papers and years in congress? >> that is an important question. i'm pleased to say that my alma mater at ucla is taking some interest. hopefully, some of that work will be of value to researchers sometime out there. >> you have expressed optimism and interest of what your future might hold but it has to be difficult leaving this institution after so many years. this has been most of your adult life, your way of life. how are you using these last few weeks here, still as a voting member of congress? is the experience -- does it feel different saying this might be the last time i will do this? >> i was looking at my cad and wondering how many more votes i have left. if i thought this was the end of impacting public affairs i would be very nostalgic. we're looking at it as another chapter in life -- the book of life that we look forward to. >> do you plan to make a good- bye speech on the floor? >> i said a
Search Results 0 to 4 of about 5 (some duplicates have been removed)